What Is Rejection Sensitive Dysphoria?

Rejection Sensitive Dysphoria, also known as RSD, is a phenomenon that occurs when a person experiences extreme emotional distress after instances of rejection. The rejection does not have to be severe for RSD to occur– simple instances of rejection, such as not agreeing on where to go for dinner or what to watch on TV, can trigger a dysphoric reaction. RSD is not a reasonable response, which is why it can have such a severe impact on those who experience it. RSD is not classified as a medical condition on its own, but rather most often presents as a comorbidity with ADHD. It has also been linked with other mood disorders like bipolar. It’s important to note that rejection sensitive dysphoria is not a personal failing, but a manifestation of an underlying trauma or condition. Accepting this is the first step in being able to manage and overcome RSD.

Symptoms of Rejection Sensitive Dysphoria

Rejection can, and often does, provoke an emotional response in all of us. What marks RSD is that this response is inappropriate for the circumstance, and can last for days or longer after the rejection. Symptoms of Rejection Sensitive dysphoria can vary from person to person, but some common symptoms include:

• Chronically low self-esteem 
• Inability or trouble containing emotions after being rejected – such as fits of anger or tears
• Sudden drops into depression or anxiety, such as those typically hallmarked by bipolar
• Avoidance of tasks, big or small, that could end in failure 
• People pleasing behavior 
• Fear or apprehension of authority figures
• Perfectionism or over compensation for internal feelings of shortcomings
• Isolating behaviors 
• Stage fright, fear of public speaking or social awkwardness even around friends and family

It’s important to note that these symptoms often need to be co-occurring or chronic in order to be categorized as RSD. As we’ve mentioned, RSD is not a formal medical diagnosis, but rather a suite of issues that may be brought on by a traumatic event or pre-existing condition.

RSD vs rejection sensitivity

RSD and rejection sensitivity are often mentioned in the same circles. However, there is a difference between dysphoria and sensitivity. Dysphoria often describes a stronger feeling– linguistically, it is the opposite of euphoria. Those experiencing dysphoria can’t separate how they feel from the reality of the situation. Dysphoria causes both emotional dysregulation and cognitive dissonance , while rejection sensitivity only causes emotional dysregulation.

Causes of Rejection Sensitive Dysphoria

Because RSD co-occurs with ADHD most often, which has a strong genetic component, there are theories that it could be genetic. What is known is that the communication center of the brain, which handles things like processing rejection, does not function the same way in a brain with ADHD as a brain without ADHD. There is less filtering on the communication center in people with ADHD, meaning that emotional reactions occur quicker, more heightened and with less time to process. This can lead to phenomena like RSD.

How To Deal With Rejection Sensitive Dysphoria

If you are experiencing rejection sensitivity dysphoria, there are many ways that you can help temper your emotional reaction in your day to day life. The management of RSD often goes hand in hand with management of underlying causes that can influence RSD, such as bipolar or ADHD.

Therapy

Therapy can be an incredible tool for managing emotional dysregulation and cognitive dissonance, which are big influencers for RSD. There are several types of therapy that can help you manage your dysphoric feelings and reactions, including:

• Cognitive Behavioral Therapy (CBT): CBT is a structured, time-limited psychotherapy that aims to change patterns of thinking or behavior that are causing people’s problems. It focuses on identifying and challenging negative thought patterns and beliefs, helping develop healthier thinking and coping strategies.
• Dialectical Behavioral Therapy (DBT): DBT is a type of cognitive-behavioral therapy that emphasizes the importance of balancing acceptance and change. It is particularly effective for those with borderline personality disorder and involves skills training in areas such as mindfulness, emotional regulation, distress tolerance and interpersonal effectiveness.
• Exposure Therapy: Exposure therapy is a psychological treatment that helps individuals confront their fears in a controlled and gradual way. It involves exposing the patient to the feared object or context without any danger, to help them overcome their anxiety and reduce avoidance behaviors.

Medication

While there is no specific medication for RSD, your use of medication can affect it. If you are taking medication for a related issue, such as ADHD or bipolar, it is crucial that you are consistent with your medication. Inconsistencies in taking medication can worsen symptoms, or even induce manic episodes. Just like how you should never start a medication without talking to your medical care team, similarly you shouldn’t suddenly stop taking medication without medical advice.

Mental health treatment programs

For those who have more serious cases of RSD, or RSD as a symptom of another disorder or traumatic event, then a mental health treatment program may be right for you. These programs offer a more in-depth treatment regiment, often meeting several days a week for a few hours. Old Vineyard behavioral hospital, in Winston-Salem, NC,  offers a variety of mental health programming in order to fit our community’s needs. Learn about our program offerings and techniques we use during treatment on our services page, or call today at 855-602-5920 to learn about program eligibility.

Old Vineyard Behavioral Health Services

Old Vineyard Behavioral Health Services is a treatment center that provides compassionate inpatient and outpatient treatment to help those achieve meaningful mental health and wellness. We treat a variety of behavioral health disorders including trauma, depression, mood disorders and more.

Our team of dedicated staff pride themselves on creating a safe and welcoming environment for all of our patients and their loved ones. Some of our services include our treatment, specialty and outpatient programs. Located in Winston-Salem, North Carolina, we provide a beautiful, campus-like atmosphere.

To schedule a consultation with us or for more information, please call 855-602-5920.